Proposed Child Mental-Health Reforms Are Posted Now on Web For Public Comment Period

JOSH KOVNER, jkovner@courant.com

How are the Newtown shootings continuing to have an impact on mental health in Connecticut?

A series of proposed reforms of the child mental-health network in Connecticut -- mandated by the legislature after the Newtown school shootings 21 months ago and released Friday – seek to make a fragmented system more accessible, accountable, and focused on early detection and intervention.

A draft of the plan was posted at http://www.plan4children.org, and will remain live through Sept. 12 for a period of public comment. The final plan is due at the legislature in October.

One key reform would pool money for treatment that is now split between several state agencies. In theory, this would help reduce the fragmentation plaguing the system, and increase efficiency.

Officials said in a conference call Friday afternoon that such a pool could contain well over $300 million in public funding that already exists "as separate funding streams."

It's possible additional public money would be needed to put the reforms in place, the officials said, adding that they hoped to encourage wider participation from commercial and employer-sponsored insurance plans.

As many as 20 percent of Connecticut's 156,000 have mental-health needs.

The draft was shaped, in part, by input from parents and advocates.

At public forums since March, 1,000 parents shared personal experiences with a system that is largely overwhelmed, lacks adequate mental health screening for children, and is stacked against middle-class families with commercial insurance. And each of those parents spoke for many others.

"When we listen to families, it is clear they have so much to teach us about how to make further improvements," DCF Commissioner Joette Katz said Friday. "This public comment period gives the families a chance to see how well we heard what they said and to ensure we have effectively built their perspective into the plan and into the services."

The plan envisions "a fairly substantial reorganization of the system, with an improved level of accountability, and a heavy emphasis on early detection and screening ,'' said Jeff Vanderploeg, of the Child Health and Development Institute.

Kristina Stevens of DCF said the plan stops short of recommending mandating mental-health screening for children.

The draft of the Connecticut Children's Behavioral Health Plan targets several major areas for improvement:

At the information forums in the spring and earlier this summer, the parents had identified several categories of problems, said Yale University's Michael Hoge, clinical professor of psychology and a consultant with the project. These included:

-- Early Prevention: Children are routinely screened for medical problems but not mental health. Fewer than four out of 10 children are screened for autism, yet the number of children diagnosed with the condition is increasing rapidly.

-- Consistency: Some towns have plentiful, high-quality mental health programs in the community and in the schools; other towns have next to nothing, particularly in the northeast, northwest, and southwest areas of the state. Some parents have moved just so their children can have a better shot at treatment. Some local police departments work well with mental health professionals in town; others hardly collaborate at all.

-- Access: Hospital emergency departments are overwhelmed with children needing immediate mental health treatment and many community programs have long waiting lists. Children served by the Department of Children and Families or in the juvenile justice system have better access to treatment than children who aren't involved with the system.

One parent was told by an agency: "You're holding it together for now; come back when things fall apart." Another parent described purposely letting her child's condition deteriorate so the family couldn't be denied services.

-- Insurance: Those with commercial insurance reported far less access to treatment services than those on the HUSKY plan, or those who could afford to pay out of their pockets. And too few doctors accept Medicaid.

-- Autism: There is a severe lack of services for 18-year-olds who are trying to make the transition to adulthood. They need more job opportunities, housing, training in life skills; even learning to drive is a major problem.